Chinese General Practice ›› 2023, Vol. 26 ›› Issue (35): 4439-4445.DOI: 10.12114/j.issn.1007-9572.2023.0248
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Received:
2023-03-27
Revised:
2023-06-14
Published:
2023-12-15
Online:
2023-07-25
Contact:
LIU Xiaojun
通讯作者:
刘小军
作者简介:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0248
项目 | 分值 |
---|---|
年龄>73岁 | 1 |
脑卒中史 | 2 |
入院血糖水平>10.6 mmol/L | 1 |
血肌酐水平>132.6 μmol/L | 1 |
急诊PCI后TIMI血流分级<3级 | 2 |
血乳酸水平>5 mmol/L | 2 |
Table 1 IABP-SHOCK Ⅱ scoring criteria
项目 | 分值 |
---|---|
年龄>73岁 | 1 |
脑卒中史 | 2 |
入院血糖水平>10.6 mmol/L | 1 |
血肌酐水平>132.6 μmol/L | 1 |
急诊PCI后TIMI血流分级<3级 | 2 |
血乳酸水平>5 mmol/L | 2 |
组别 | 例数 | 性别(男/女) | 年龄(岁) | BMI(kg/m2) | 吸烟史〔例(%)〕 | 高血压史〔例(%)〕 | 糖尿病史〔例(%)〕 | 高脂血症史〔例(%)〕 | 脑卒中史〔例(%)〕 | 陈旧性心肌梗死史〔例(%)〕 |
---|---|---|---|---|---|---|---|---|---|---|
A组 | 42 | 28/14 | 60.4±9.6 | 24.4±2.2 | 17(40.5) | 20(47.6) | 24(57.1) | 10(23.8) | 5(11.9) | 6(14.3) |
B组 | 40 | 26/14 | 62.7±8.7 | 24.4±2.7 | 14(35.0) | 23(57.5) | 17(42.5) | 11(27.5) | 7(17.5) | 9(22.5) |
χ2(t)值 | 0.025 | -1.134a | -0.087a | 0.261 | 0.802 | 1.757 | 0.146 | 0.513 | 0.925 | |
P值 | 0.874 | 0.260 | 0.931 | 0.609 | 0.370 | 0.185 | 0.702 | 0.474 | 0.336 |
Table 2 Baseline information of patients in both groups
组别 | 例数 | 性别(男/女) | 年龄(岁) | BMI(kg/m2) | 吸烟史〔例(%)〕 | 高血压史〔例(%)〕 | 糖尿病史〔例(%)〕 | 高脂血症史〔例(%)〕 | 脑卒中史〔例(%)〕 | 陈旧性心肌梗死史〔例(%)〕 |
---|---|---|---|---|---|---|---|---|---|---|
A组 | 42 | 28/14 | 60.4±9.6 | 24.4±2.2 | 17(40.5) | 20(47.6) | 24(57.1) | 10(23.8) | 5(11.9) | 6(14.3) |
B组 | 40 | 26/14 | 62.7±8.7 | 24.4±2.7 | 14(35.0) | 23(57.5) | 17(42.5) | 11(27.5) | 7(17.5) | 9(22.5) |
χ2(t)值 | 0.025 | -1.134a | -0.087a | 0.261 | 0.802 | 1.757 | 0.146 | 0.513 | 0.925 | |
P值 | 0.874 | 0.260 | 0.931 | 0.609 | 0.370 | 0.185 | 0.702 | 0.474 | 0.336 |
组别 | 例数 | MAP(mmHg) | CI〔L·min-1·(m2)-1〕 | GFR(mL/min) | ||||||
---|---|---|---|---|---|---|---|---|---|---|
治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | ||
A组 | 42 | 58.6±4.9 | 76.6±7.5a | 79.6±9.4a | 1.80±0.12 | 2.03±0.24a | 2.21±0.18ab | 55.1±8.7 | 65.7±12.9a | 67.9±19.7a |
B组 | 40 | 56.1±7.7 | 80.1±8.3ac | 84.3±10.5ac | 1.76±0.09 | 2.20±0.17ac | 2.31±0.15abc | 57.6±9.0 | 74.0±15.7ac | 77.0±16.6ac |
F值 | F时间=242.114,F交互=5.057,F组间=3.007 | F时间=307.275,F交互=9.935,F组间=7.838 | F时间=57.476,F交互=2.533,F组间=7.146 | |||||||
P值 | P时间<0.001,P交互=0.009,P组间=0.087 | P时间<0.001,P交互<0.001,P组间=0.006 | P时间<0.001,P交互=0.086,P组间=0.009 | |||||||
组别 | Lac(mmol/L) | cTnI(μg/L) | BNP(ng/L) | |||||||
治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | ||
A组 | 11.31±3.26 | 5.76±1.64a | 2.53±1.05ab | 31.53±12.46 | 13.68±5.38a | 1.32±0.40ab | 2 293.4±1 020.8 | 1 403.0±626.0a | 917.6±363.4ab | |
B组 | 11.45±2.91 | 4.90±1.47ac | 2.09±0.88abc | 30.78±9.58 | 9.63±5.70ac | 0.78±0.37abc | 2 470.1±1 206.9 | 1 276.8±499.9a | 887.9±346.4ab | |
F值 | F时间=542.804,F交互=3.382,F组间=1.103 | F时间=357.666,F交互=4.301,F组间=3.143 | F时间=113.153,F交互=1.650,F组间=0.001 | |||||||
P值 | P时间<0.001,P交互=0.039,P组间=0.297 | P时间<0.001,P交互=0.017,P组间=0.080 | P时间<0.001,P交互=0.199,P组间=0.980 |
Table 3 Clinical indicators of patients in the two groups before,24 and 72 h after combined treatment
组别 | 例数 | MAP(mmHg) | CI〔L·min-1·(m2)-1〕 | GFR(mL/min) | ||||||
---|---|---|---|---|---|---|---|---|---|---|
治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | ||
A组 | 42 | 58.6±4.9 | 76.6±7.5a | 79.6±9.4a | 1.80±0.12 | 2.03±0.24a | 2.21±0.18ab | 55.1±8.7 | 65.7±12.9a | 67.9±19.7a |
B组 | 40 | 56.1±7.7 | 80.1±8.3ac | 84.3±10.5ac | 1.76±0.09 | 2.20±0.17ac | 2.31±0.15abc | 57.6±9.0 | 74.0±15.7ac | 77.0±16.6ac |
F值 | F时间=242.114,F交互=5.057,F组间=3.007 | F时间=307.275,F交互=9.935,F组间=7.838 | F时间=57.476,F交互=2.533,F组间=7.146 | |||||||
P值 | P时间<0.001,P交互=0.009,P组间=0.087 | P时间<0.001,P交互<0.001,P组间=0.006 | P时间<0.001,P交互=0.086,P组间=0.009 | |||||||
组别 | Lac(mmol/L) | cTnI(μg/L) | BNP(ng/L) | |||||||
治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | 治疗前 | 治疗后24 h | 治疗后72 h | ||
A组 | 11.31±3.26 | 5.76±1.64a | 2.53±1.05ab | 31.53±12.46 | 13.68±5.38a | 1.32±0.40ab | 2 293.4±1 020.8 | 1 403.0±626.0a | 917.6±363.4ab | |
B组 | 11.45±2.91 | 4.90±1.47ac | 2.09±0.88abc | 30.78±9.58 | 9.63±5.70ac | 0.78±0.37abc | 2 470.1±1 206.9 | 1 276.8±499.9a | 887.9±346.4ab | |
F值 | F时间=542.804,F交互=3.382,F组间=1.103 | F时间=357.666,F交互=4.301,F组间=3.143 | F时间=113.153,F交互=1.650,F组间=0.001 | |||||||
P值 | P时间<0.001,P交互=0.039,P组间=0.297 | P时间<0.001,P交互=0.017,P组间=0.080 | P时间<0.001,P交互=0.199,P组间=0.980 |
组别 | 例数 | 罪犯血管〔例(%)〕 | 病变血管支数〔例(%)〕 | AMI类型〔例(%)〕 | ||||||
---|---|---|---|---|---|---|---|---|---|---|
LM | LAD | LCX | RCA | 1支 | 2支 | 3支 | STEMI | NSTEMI | ||
A组 | 42 | 11(26.2) | 27(64.3) | 17(40.5) | 13(31.0) | 4(9.5) | 16(38.1) | 22(52.4) | 26(61.9) | 16(38.1) |
B组 | 40 | 8(20.0) | 24(60.0) | 12(30.0) | 15(37.5) | 2(5.0) | 10(25.0) | 28(70.0) | 30(75.0) | 10(25.0) |
χ2(Z)值 | 0.441 | 0.160 | 0.984 | 0.391 | 1.638a | 1.623 | ||||
P值 | 0.507 | 0.689 | 0.321 | 0.532 | 0.102 | 0.203 | ||||
组别 | PCI后TIMI血流3级〔例(%)〕 | IABP-SHOCK Ⅱ评分〔M(P25,P75),分〕 | 正性肌力药物〔例(%)〕 | 血管活性药物〔例(%)〕 | ||||||
多巴酚丁胺 | 去乙酰毛花苷注射液 | 左西孟旦 | 多巴胺 | 去甲肾上腺素 | 间羟胺 | |||||
A组 | 38(90.5) | 3.0(3.0,4.0) | 22(52.4) | 23(54.8) | 20(47.6) | 32(76.2) | 36(85.7) | 25(59.5) | ||
B组 | 35(87.5) | 4.0(3.0,5.0) | 26(65.0) | 21(52.5) | 16(40.0) | 33(82.5) | 16(65.0) | 15(37.5) | ||
χ2(Z)值 | 0.186 | -1.605a | 1.344 | 0.042 | 0.483 | 0.496 | 4.767 | 3.977 | ||
P值 | 0.666 | 0.108 | 0.246 | 0.837 | 0.487 | 0.481 | 0.029 | 0.046 | ||
组别 | ICU住院时间〔M(P25,P75),d〕 | 联合辅助时间〔M(P25,P75),d〕 | 间隔辅助时间〔M(P25,P75),d〕 | 血制品输注比例〔例(%)〕 | CRRT比例〔例(%)〕 | |||||
红细胞 | 血浆 | 血小板 | 冷沉淀 | |||||||
A组 | 12.0(6.0,18.0) | 144.0(93.8,213.8) | 15.3(9.8,26.2) | 22(52.4) | 23(54.8) | 6(14.3) | 9(21.4) | 13(31.0) | ||
B组 | 14.5(6.0,18.0) | 138.0(93.3,193.0) | 9.0(1.1,35.0) | 23(56.1) | 21(51.2) | 8(20.0) | 6(15.0) | 7(17.5) | ||
χ2(Z)值 | -1.343a | -0.371a | -1.638a | 1.254 | 0.106 | 1.611 | 0.566 | 2.010 | ||
P值 | 0.179 | 0.710 | 0.101 | 0.534 | 0.948 | 0.447 | 0.452 | 0.156 |
Table 4 Comparison of treatment between the two groups
组别 | 例数 | 罪犯血管〔例(%)〕 | 病变血管支数〔例(%)〕 | AMI类型〔例(%)〕 | ||||||
---|---|---|---|---|---|---|---|---|---|---|
LM | LAD | LCX | RCA | 1支 | 2支 | 3支 | STEMI | NSTEMI | ||
A组 | 42 | 11(26.2) | 27(64.3) | 17(40.5) | 13(31.0) | 4(9.5) | 16(38.1) | 22(52.4) | 26(61.9) | 16(38.1) |
B组 | 40 | 8(20.0) | 24(60.0) | 12(30.0) | 15(37.5) | 2(5.0) | 10(25.0) | 28(70.0) | 30(75.0) | 10(25.0) |
χ2(Z)值 | 0.441 | 0.160 | 0.984 | 0.391 | 1.638a | 1.623 | ||||
P值 | 0.507 | 0.689 | 0.321 | 0.532 | 0.102 | 0.203 | ||||
组别 | PCI后TIMI血流3级〔例(%)〕 | IABP-SHOCK Ⅱ评分〔M(P25,P75),分〕 | 正性肌力药物〔例(%)〕 | 血管活性药物〔例(%)〕 | ||||||
多巴酚丁胺 | 去乙酰毛花苷注射液 | 左西孟旦 | 多巴胺 | 去甲肾上腺素 | 间羟胺 | |||||
A组 | 38(90.5) | 3.0(3.0,4.0) | 22(52.4) | 23(54.8) | 20(47.6) | 32(76.2) | 36(85.7) | 25(59.5) | ||
B组 | 35(87.5) | 4.0(3.0,5.0) | 26(65.0) | 21(52.5) | 16(40.0) | 33(82.5) | 16(65.0) | 15(37.5) | ||
χ2(Z)值 | 0.186 | -1.605a | 1.344 | 0.042 | 0.483 | 0.496 | 4.767 | 3.977 | ||
P值 | 0.666 | 0.108 | 0.246 | 0.837 | 0.487 | 0.481 | 0.029 | 0.046 | ||
组别 | ICU住院时间〔M(P25,P75),d〕 | 联合辅助时间〔M(P25,P75),d〕 | 间隔辅助时间〔M(P25,P75),d〕 | 血制品输注比例〔例(%)〕 | CRRT比例〔例(%)〕 | |||||
红细胞 | 血浆 | 血小板 | 冷沉淀 | |||||||
A组 | 12.0(6.0,18.0) | 144.0(93.8,213.8) | 15.3(9.8,26.2) | 22(52.4) | 23(54.8) | 6(14.3) | 9(21.4) | 13(31.0) | ||
B组 | 14.5(6.0,18.0) | 138.0(93.3,193.0) | 9.0(1.1,35.0) | 23(56.1) | 21(51.2) | 8(20.0) | 6(15.0) | 7(17.5) | ||
χ2(Z)值 | -1.343a | -0.371a | -1.638a | 1.254 | 0.106 | 1.611 | 0.566 | 2.010 | ||
P值 | 0.179 | 0.710 | 0.101 | 0.534 | 0.948 | 0.447 | 0.452 | 0.156 |
组别 | 例数 | 肺部感染 | AKI | 凝血功能障碍 | 消化道出血 | 下肢血栓 | 神经系统并发症 | MODS | 出院生存 |
---|---|---|---|---|---|---|---|---|---|
A组 | 42 | 21(50.0) | 25(59.5) | 8(19.0) | 11(26.3) | 9(21.4) | 10(23.8) | 7(16.7) | 16(38.1) |
B组 | 40 | 24(60.0) | 14(35.0) | 9(22.5) | 13(32.5) | 7(17.5) | 12(30.0) | 4(10.0) | 24(60.0) |
χ2值 | 0.827 | 4.940 | 1.073 | 0.394 | 0.201 | 0.400 | 0.784 | 3.935 | |
P值 | 0.363 | 0.026 | 0.585 | 0.530 | 0.654 | 0.527 | 0.376 | 0.047 |
Table 5 Related complications and prognosis of patients in both groups
组别 | 例数 | 肺部感染 | AKI | 凝血功能障碍 | 消化道出血 | 下肢血栓 | 神经系统并发症 | MODS | 出院生存 |
---|---|---|---|---|---|---|---|---|---|
A组 | 42 | 21(50.0) | 25(59.5) | 8(19.0) | 11(26.3) | 9(21.4) | 10(23.8) | 7(16.7) | 16(38.1) |
B组 | 40 | 24(60.0) | 14(35.0) | 9(22.5) | 13(32.5) | 7(17.5) | 12(30.0) | 4(10.0) | 24(60.0) |
χ2值 | 0.827 | 4.940 | 1.073 | 0.394 | 0.201 | 0.400 | 0.784 | 3.935 | |
P值 | 0.363 | 0.026 | 0.585 | 0.530 | 0.654 | 0.527 | 0.376 | 0.047 |
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